总结1例复杂胸主动脉夹层聋哑患者行胸主动脉腔内隔绝伴逆行穿刺原位开窗分支支架置入的护理经验。护理要点:通过图文结合手势交流,实现有效沟通;手术室专科护理团队参与术前多学科协作讨论,制订阶梯式应急预案;维持目标血压和心率,预防瘤体破裂;密切监测脑氧饱和度,预防神经系统并发症;集束化感染防控,降低手术感染风险;精准控制肝素使用量,预防继发性出血或致命性血栓形成;实施分阶段目标体温管理,减少颅脑代谢需求;动态监测神经功能,积极预防脑卒中;加强术后活动管理,预防支架移位;通过“互联网+”护理随访,助力患者康复。经过多学科救治及精心护理,患者手术顺利,恢复良好,术后11 d病情平稳,顺利出院。

This case report summerizes the nursing experience of one deaf-mute patient with complex thoracic aortic dissection who underwent endovascular aortic repair (EVAR) of the aortic arch combined with retrograde puncture,in-situ fenestration and branch stent implantation. The key nursing points were as follows: effective communication was achieved through the combination of pictures, texts and gestures; the operating room specialized nursing team participated in preoperative multidisciplinary collaborative discussions and formulated stepped emergency plans;target blood pressure and heart rate were maintained to prevent aneurysm rupture; cerebral oxygen saturation was closely monitored to prevent neurological complications;bundle infection prevention and control measures were implemented to reduce the risk of surgical infection;the dosage of heparin was accurately controlled to prevent secondary hemorrhage or fatal thrombosis;phased target temperature management was carried out to reduce craniocerebral metabolic demand;dynamic monitoring of neurological function was performed to actively prevent stroke;postoperative activity management was strengthened to prevent stent displacement;and Internet plus nursing follow-up was conducted to facilitate the patient's rehabilitation. With multidisciplinary treatment and meticulous nursing care, the patient underwent successful surgery with favorable recovery, and was discharged smoothly in stable condition on the 11th day after operation.

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